Saint Agnes Spine & Specialty Surgery, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

SAINT AGNES SPINE & SPECIALTY SURGERY, LLC

Practice address

2365 E Fir Ave
Fresno, CA 93720-8016

Phone

(559) 797-9100

NPI assigned

Apr 30, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jenetha D Moran

Title

Authorized Official

Phone

(972) 763-3893

Specialties & licenses 1

Addresses

Other names 1

• Saint Agnes Spine & Specialty Surgery Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525046400000",
    "number": "1467940916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2365 E FIR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208016",
            "telephone_number": "559-797-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 E FIR AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937208016",
            "telephone_number": "559-797-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT AGNES SPINE & SPECIALTY SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-04-30",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "JENETHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "972-763-3893"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Saint Agnes Spine & Specialty Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Saint Agnes Medical Center
• Saint Agnes Medical Foundation
• Saint Agnes Medical Providers
• Saint Agnes Medical Providers Inc
• Saint Agnes Pathology Medical Group
• Saima Sajid-Crockett, M.D.
• Leeann Toshie Sakamoto Cunningham, RN
• Taylor Emiko Sakamoto, PA-C
• Carolyn Midori Sakauye, MD
• Tina Sakha

• All providers in Fresno, CA
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.